Journal of Health and Medical Sciences
Published: 18 July 2022
Health Shocks and Coping Mechanisms in North Central Nigeria: The Gender Perspective
Oluwayemisi D. Adegboye, Mojirola M. Fasiku, Demilade O. Ibirongbe, Tanimola M. Akande
Kwara State Health Insurance Agency (Nigeria), University of Ilorin Teaching Hospital (Nigeria), University of Medical Sciences (Nigeria)
Download Full-Text Pdf
Keywords: Female, Health Shocks, Out-of-Pocket Payments, Healthcare, Coping Mechanism
Introduction: Reliance on out-of-pockets (OOP) payments for health services has continued to hamper access to quality healthcare across Nigeria. Socio-demographic and socio-economic characteristics of the gender of the household head as it influences and impacts health shocks and OOP payments have received very little attention globally. This study investigated the gender perspective on health shocks, health expenditures and coping mechanisms in North Central, Nigeria. Methods: This is a cross-sectional analytical study involving both quantitative and qualitative data collection methods. A total of 1,192 households were studied using multi-stage sampling technique in both rural and urban communities in North Central, Nigeria. Data was analysed with SPSS version 20, and qualitative analysis was done by thematic analysis. Results: The finding showed that 458 (38.4%) of the respondents were female-headed households (FHHs). Female-headed households were less educated, earned lower income, resided more in rural communities and were less insured than male-headed households (MHHs). Health shocks were higher among the FHHs and they also pay higher percentage of their household expenditure for healthcare through higher OOP payments. Also, more FHHs experienced Catastrophic Health Expenditure (CHE) and reported effects of health shocks on reduction in food consumption and loss of income than MHHs. Age, income, occupation and household size are all factors that influenced health shocks in this study. Conclusions: Innovative ways to financially protect women must be employed, to close up the equity gap and bring Nigeria closer to achieving UHC.
Adegboye, O. D., Rotimi, B. F. & Akande, T. M. (2018). Catastrophic health expenditure as a result of health shocks: challenge to universal health coverage in Nigeria. Savanna Journal of medical Research and Practice, 7(1), 1-6. https://doi.org/10.4314/sjmrp.v7i1.1
Adisa, O. (2015). Investigating determinants of catastrophic health spending among poorly insured elderly households in Urban Nigeria. International journal Equity and Health, 14(79). https://doi.org/10.1186/s12939-015-0188-5
Akinbi, J. O. & Akinbi, Y. A. (2015). Gender Disparity in Enrolment into Basic Formal Education in Nigeria: Implications for National Development. Africa Research Review, 9(3), 11-13. https://.doi.org/10.4314/afrrev.v9i3.2
Alawode, G. O. & Adewole, D. A. (2021). Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health. 21(124). https://doi.org/10.1186/s12889-020-10133-5
Aregbeshola, B. S. & Khan, S. M. (2018). Predictors of enrolment in the National Health Insurance Scheme among women of reproductive age in Nigeria. International Journal of Health Policy and Management, 7(11), 1015-1023. https://doi.org/10.15171/ijhpm.2018.68
Asad, I. & Jaai, P. (2017). Heterogeneous Effects of Health Shocks in Developed Countries: Evidence from Australia. Monash Economics Working Papers 15-17, Monash University, Department of Economics. Discussion number 15/17. ISSN number 14415429. Accessed on 9 Sept 2021 from: https://ideas.repec.org/p/mos/moswps/2017-15.
Azzani, M., Roslani, C. & Su, T.T. (2019). Determinants of Household Catastrophic Health Expenditure: A Systematic Review. Malaysia Journal of Medical Science, 26(1), 15-43. https://doi.org/10.21315/mjms2019.26.1.3
Babatunde, R.O., Oyedeji, O., Omoniwa, E. & Adenuga, A. (2016). Effect of community based health insurance on the livelihood of rural household in Kwara state, Nigeria. Journal of Agricultural Faculty of Gaziosmanpasa University, 33(2), 19-27. https://doi.org/10.13002/jafag914
Bonfer, I. & Gustafsson – Wright, E. (2017). Health shocks, coping strategies and forgone healthcare among agricultural households in Kenya. Global public health journal,12(11), 1369-1390. https://doi.org/10.1080/17441692.2015.1130847
Dawaki, S., Al-Mekhlafi, H. M., Ithoi, I. et al. (2016). Is Nigeria winning the battle against malaria? Prevalence, risk factors and KAP assessment among Hausa communities in Kano State. Malaria Journal, 15:351 https://doi.org/10.1186/s12936-016-1394-3
Dhanaraj, S. (2016). Economic vulnerability to Health shocks and coping strategies: Evidence from Andhra Pradesh, India. Health policy plan, 31(6), pp 749 -758. https://doi.org/10.1093/heapol/czv127
Doss, C., Oduro, A.D., Deere, C. D., Swaminathan, H., Baah-Boatena, W. & Suchitra, J.Y. (2018). Assets and shocks. A gendered analysis of Ecuador, Ghana and Karnataka. Canadian journal of development studies, 39(1), 1-8. https://doi.org/10.1080/02255189.2017
Ewelukwa, O., Onoka, C. & Onwujekwe, O. (2013). Viewing health expenditures, payment and coping mechanisms with an equity lens in Nigeria. BMC Health Services Research, 13(87). https://doi.org/10.1186/1472-6963-13-87.
Holmes, R., Akinrimisi, B., Morgan, J. & Buck, R. (2012). Social protection in Nigeria Mapping programmes and their effectiveness. London Overseas Development Institute.
Ibukun, C. & Komolafe, E. (2018). Household Catastrophic Health Expenditure: Evidence from Nigeria. Microeconomics and macroeconomics journal, 6(1), 1-8. https://doi.org/ 10.5923/j.m2economics.20180601.01
Iloka, C. E., Edeme, R. K., Edeh, R. A., & Ikeagu, U. F. (2018). Equity in Financing Health Care Services in Nigeria. Journal of Economics and Sustainable Development, 9(3), Accessed on 19 Jun. 2021 from: www.iiste.org ISSN 2222-1700 (Paper) ISSN 2222-2855 (Online)
Khurshid, A. & Ajay, M. (2014). Economic impacts of health shocks on households in low and middle income countries: a review of the literature. Globalization and Health journal, 10(21), 6-18. https://doi.org/10.1186/1744-8603.
Kwara State Government Media, Kwara State, Nigeria. (2016). Accessed on 5 May 2021 from: http://www.kwarastate.gov.ng
Li, Y., Wu, Q., Xu, L. et al. (2012). Factors affecting catastrophic health expenditure and impoverishment from medical expenses in China: policy implications of Universal Health Insurance. Bulletin of the World Health Organization, 90(9), 664-671. https://doi.org/10.2471/BLT.12.102178.
Lieve, A. & Xu, K. (2008). “Coping with Out-of-Pocket Health Payments: Empirical Evidence from 15 African Countries.” Bulletin of the World Health Organization, 86, 849-8.
Mitra, S., Palmer, M., Mont, D. & Groce, N. (2016). Can Households Cope with Health Shocks in Vietnam? Wiley online library, 25(7), 888-907. https://doi.org/10. 1002/hec 3196
National Bureau of Statistics. Living Standard Measurement Study, Nigeria General Household Survey–Panel 2015/16, Wave 3. NGA_2015_GHSP-W3_v02_M Accessed on 6 May, 2022
National Population Commission Abuja, Nigeria, (2019). Nigeria Demographic and Health Survey 2018. Accessed on 6 May, 2022 from https://dhsprogram.com
Obansa, S. A. & Orimisan. A. (2013). Health care financing: Prospects and Challenges. Mediterranean Journal of Sciences. 4(1):221-236. https://doi.org/10.5901/mjss.2013.v4n1p221
Odeyemi, I. & Nixon, J. (2013). Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: A review-based comparative analysis. International journal of equity health, 12(9). https://doi.org/10.1186/1475-9276-12-9
Olaniyan, O., Chukwuedo, S. O. & Obafemi, F. N. (2013). Equity in health care expenditure in Nigeria. International Journal of Finance and Banking Studies, 2(3). 76-88. ISSN: 2147-4486 Accessed on 6 May, 2021 from: https://ideas.repec
Omotosho, O. & Ichoku, H. E. (2016). Financial protection and Universal Health Coverage in Nigeria. Iiste journal 51. ISSN (Online) 2224-8951
Onisanwa, D. I. & Olaniyan, O. (2019). Health shocks and consumption smoothing among rural households in Nigeria.journal of Economics and management, 36(2). 45-66. https://doi.org/ 10.22367/jem.2019.36.03
Oyewale, M. M., Folusho, M. B. & Adeniyi, F. F. (2018). Housing type and risk of malaria among under-five children in Nigeria: evidence from the malaria indicator survey. Malaria Journal, open access. 17:311. https://doi.org/10.1186/s12936-018-2463-6
Psaki, S. R., Siedman, J. C., Miller, M. et al.(2014). Measuring socioeconomic status in multi-country studies: results from the eight-country MAL-ED study. Population Health Metrics Journal, 12 (8). https://doi.org/10.1186/1478-7954-12-8
Rice, T., Quentin, W., Anell, A., et al. (2018). Revisiting out-of-pocket requirements: trends in spending, financial access barriers and policy in ten high income countries. BMC Health service Research, 18, 371. https://doi.org/10.1186/s12913-018-3185-8.
Socio – economic questionnaire. Kwara central Community health survey, AIGHD. 2013
Sparrow, R., Van de Poel, E., Hadiwidjaja, G., Yumna, A. & Warda, N. (2014). Coping with the economic consequences of ill health. Health economics journal. https://doi.org/10,1002/hec.2945
Urama, C. E., Adewoyin, Y., Ukwueze, E. R. & Ene J. C. (2019). Socioeconomic status and health shocks; analysis of coping strategies in rural households of Enugu State, Nigeria. African Population Studies, 33(1), 4766-4774. Accessed 1 May, 2022 from: http://www.researchgate.net/publication/332442302
Uzochukwu, A., & Uju, E. (2012). Implications of household’s catastrophic out–of–pocket healthcare spending in Nigeria. Journal of research in economics and international finance, 1(5), 136-140. Accessed 5 Jun. 2022 from: https://www.intereslournals.org>article